Woah, woah! Whilst imaging is essential, it is often better to carry out blood tests and other bedside observations after a clinical examination. Plus AXR is only used for obstruction/toxic megacolon. In Sally’s case, as she came in with epigastric pain radiating to the back alongside nausea and vomiting, it is essential to rule out pancreatitis by measuring serum amylase or lipase.
The serum amylase returns as 1155 U/L (normal: 40-140U/L).
Ah, a classic picture of acute pancreatitis! Which of the following is not a cause of acute pancreatitis?